An interactive tool co-designed with therapists for personalised dementia reminiscence therapy using generative AI, bridging the gap between personal photos and archive images.
“Just looking at the old items, the photos or even just hear the music can really stimulate their conversation. They will start to talk about “These are the old times…” Even if they cannot really engage in a conversation, they may start to sing. As long as they can really respond to it, I find it is meaningful for them also.”
- YC (Occupational Therapist)
Reminiscence therapy helps people with dementia reconnect with their past through sensory and emotional cues. But while the impact is clear, the tools available to therapists are often limited to outdated image books and a few antique objects in the facility that don’t resonate with clients’ memories.
support therapists in bridging cultural gaps and personalizing reminiscence therapy for richer client engagement while reducing session prep time?
/tl;dr
/process
This project was conducted over 20 months (and counting) using a research-through-design approach, outlined in the timeline below. To understand how reminiscence therapy is practiced in dementia care, I combined ethnographic observations in nursing homes, volunteer work at an active ageing centre, and semi-structured interviews with therapists, persons with dementia, and caregivers. Insights from these engagements shaped iterative prototypes that were co-developed and tested in real therapy sessions, including the development of a functional web application prototype.
This 20-month timeline shows how I moved from early field research to tested real-world deployment across care sites.
/research methods
The current service blueprint maps out the typical flow of a reminiscence therapy session, highlighting the key actions, tools, and touchpoints used by therapists. It captures how therapists prepare materials in advance, guide memory prompts during the session, and respond dynamically to clients’ emotional and cognitive states. The blueprint reveals opportunities where design interventions can support personalisation, reduce preparation burden, and better align with the embodied, improvisational nature of care work.
/insights
#1 Generic Materials Fail to Engage Meaningfully
“We usually use reminiscence books with pictures and questions, but some images are too old or irrelevant, the residents can’t relate. There’s no point doing reminiscence if the image doesn’t engage them or help them recall anything.”
- AR (Therapy Support Associate)
Many of the materials currently used in reminiscence therapy curated collections lack cultural relevance or personal resonance. While they may spark some interaction, they often fail to truly evoke memories or emotional engagement, especially for seniors with diverse backgrounds or fragmented recollections. This reduces the therapeutic potential of the session and places greater burden on therapists to fill in the gaps.
#2 High Time Cost in Material Preparation
“I created a kit previously. I looked at different topics, different themes, then I prepare, ok, from this era is maybe 1950s to 1960. So what kind of music is it? But it's really, really time consuming. Yeah. It will take a lot of manpowers to prepare that. Because we need to go and find the information, print it out then you need to laminate it, you need to do the sorting. And as time passes you need to update the kit.”
- YC (Occupational Therapist)
Therapists often invest significant time and effort sourcing, compiling, and printing materials tailored to their clients' backgrounds. This preparation work is rarely visible but is essential to running meaningful sessions. The lack of adaptable tools that support this process creates inefficiencies and leaves therapists unsupported in delivering personalised care.
#3 Memory Work Relies on Tacit Knowledge
“We really need to know what they like, what is their background, what is their interest. So that's when you go in with their (interest), then reminiscence really work.”
- PR (Therapy Aide)
Understanding how to trigger meaningful memories often depends on therapists’ accumulated tacit knowledge—unwritten, intuitive insight built over time through repeated interaction. This knowledge is difficult to externalize or transfer, making it challenging for new staff or caregivers to support reminiscence therapy at the same level of depth.
#4 Language and Cultural Barriers Hinder Connection
“Like how, how do I communicate to them back? Let's say they ask me, right. And they speak in their own language. But then I cannot answer back because I don't know what is it.”
- CH (Programme Coordinator)
Due to a lack of manpower in the care sector, many of the therapy aides hail from neighbouring countries and do not share the same cultural background as the clients. Moreover, some clients also only speak in the local languages and dialects that foreign staff struggle to understand.
/design intervention
The Rememo System
Rememo is a therapist-guided AI tool designed to support reminiscence therapy in dementia care. Instead of replacing human expertise, it augments therapists’ ability to surface personal memories through meaningful, responsive visual prompts.
Built with Node.js (Fastify + Handlebars), Rememo integrates Google Cloud Vision for OCR, supports three AI image generators, logs via Airtable, and is deployed on AWS App Runner with a mobile-first interface.
Printed Memory Card Sets
Eight themed sets of illustrated cards (e.g., family, food, school) act as tactile conversation starters to engage clients. Cards also include translations in the 4 main languages, 3 Chinese dialects and colloquial names.
Mobile Web App with OCR Scanning
Therapists scan selected cards using a phone or tablet. Optical Character Recognition (OCR) detects the card themes and triggers image generation.
AI-Generated Imagery for personalisation
Based on card combinations that describe the senior's memory, an image is generated using a fine-tuned text-to-image model, trained on a dataset of local archive imagery to maintain contextual relevance.
Therapist-Moderated Preview and Printing
Therapists preview the image and can print it using an Instax Link Wide printer for a tactile keepsake if deemed appropriate. This maintains therapist discretion and ensures emotional safety for clients.
Seamless Integration into Therapy Sessions
The system is designed to be quick, portable, and non-disruptive, supporting therapists in maintaining emotional connection and responsiveness throughout the session.
Guidance for novice therapists
Each generation provides 5 guiding questions relevant to the content of the image to guide novice therapists and ease into the conversation.
/user feedback
With the help of a therapy support aide from ECON Henderson, I conducted user testing with 6 clients with dementia in 2 group sessions and 2 individual sessions. These were what the therapists had to say about the Rememo system afterwards.
Note: This version tested was an older hardware-based prototype, the latest webapp-based version is currently undergoing another user testing study.
Increased personal relevance
“I think I find it most interesting this one is more relatable to their own memories. Because when it comes to reminiscence, we usually use this kind of books. And then some of the pictures are really too old for them, maybe itʼs not in their ages, not in their young times so when it comes to this one, they have to think back their own memories.”
Greater engagement and sharing
“So now they talk more I feel like. Now only then we know they got this in their childhood, they talk more. Now Mdm C talk about brother, want to play what. Usually is we show the picture then we talk about the picture but we donʼt really talk about themselves.”
Facilitation of Personalised Sessions
“For powerpoints, we are the one to select, but for this one, this is the topic that they select … We ask some questions but you know their memory is linked to that picture already, because we show the picture first. But this one is we ask them first, who you think in your memory, and they will start to share. But usually ours, if we show the picture, they see the picture already the memory is linked to that picture already. So we donʼt know what they want to talk about it.”
Portability and Convenience
“For me, if you ask me to use it tomorrow, I will use it for individual sessions, I will bring it to their bedside, more privacy and some residents, physically they cannot sit, so they go through these sessions, its useful and its portable to bring to the ward, near to their bedside and I will show and they can talk.”
Save time for Staff
“No need prepare powerpoint slides, save time for OT. No need OT already, OT will say this resident need reminiscence then TA will just bring lor, then ask the resident scan scan then picture come out then we will talk about it.”
/conclusion
Rememo is currently undergoing a 2-week field study with five therapists across two care sites to evaluate its integration into real-world therapy workflows. Insights from this study will inform further refinements and contribute to an academic paper exploring therapist-AI collaboration in dementia care contexts.
Check out the prototype!
